174
views
0
recommends
+1 Recommend
1 collections
    4
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Changes in Heart Rate Variability in a Premature Infant with Hydrocephalus

      case-report
      , M.D. 1 , , M.D., Ph.D. 3 , , M.D., C.Sc. 2 , , M.D., Ph.D. 2 , , M.D., Ph.D. 1 , , M.D., Ph.D. 1 , , M.D., C.Sc. 1
      AJP Reports
      Thieme Medical Publishers
      heart rate variability, newborn, hydrocephalus

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure.

          Study Design The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge).

          Results Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity.

          Conclusion Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: not found

          Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants.

          Heart rate variability (HRV) reveals information on the functional state of the autonomic nervous system (ANS). This study was initiated to assess the physiological- and maturational development of the ANS by comparing HRV data of healthy prematures with term infants. Short-term recordings of HRV in 39 premature healthy infants (29-35 weeks' gestation) were performed and compared with normative data of term infants. Frequency domain HRV parameters are computed in three frequency bands. Gestational age of newborn infants is correlated with HRV. Prematures showed significant lower HRV parameters than term infants. The most significant differences were discerned for HRV parameters reflecting parasympathetic activity, whereas the pulse of the baro-receptor reflex was similar for prematures and term infants at 0.07 Hz (0.1 Hz adults). A respiratory peak in the HF-band according to respiratory sinus arrhythmia (RSA), as is common in adults, was not detected for prematures as it is not detected in term infants. Maturation of the ANS is accompanied by increasing HRV with a pronounced increase of parasympathetic activity. These changes are measurable by short-term recordings. The physiological pulses concerning baroreceptor reflex activity and respiratory modulation were similar in prematures and term infants.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Priorities for hydrocephalus research: report from a National Institutes of Health-sponsored workshop.

            Treatment for hydrocephalus has not advanced appreciably since the advent of cerebrospinal fluid (CSF) shunts more than 50 years ago. Many questions remain that clinical and basic research could address, which in turn could improve therapeutic options. To clarify the main issues facing hydrocephalus research and to identify critical advances necessary to improve outcomes for patients with hydrocephalus, the National Institutes of Health (NIH) sponsored a workshop titled "Hydrocephalus: Myths, New Facts, and Clear Directions." The purpose of this paper is to report on the recommendations that resulted from that workshop. The workshop convened from September 29 to October 1, 2005, in Bethesda, Maryland. Among the 150 attendees was an international group of participants, including experts in pediatric and adult hydrocephalus as well as scientists working in related fields, neurosurgeons, laboratory-based neuroscientists, neurologists, patient advocates, individuals with hydrocephalus, parents, and NIH program and intramural staff. Plenary and breakout sessions covered injury and recovery mechanisms, modeling, biomechanics, diagnosis, current treatment and outcomes, complications, quality of life, future treatments, medical devices, development of research networks and information sharing, and education and career development. The conclusions were as follows: 1) current methods of diagnosis, treatment, and outcomes monitoring need improvement; 2) frequent complications, poor rate of shunt survival, and poor quality of life for patients lead to unsatisfactory outcomes; 3) investigators and caregivers need additional methods to monitor neurocognitive function and control of CSF variables such as pressure, flow, or pulsatility; 4) research warrants novel interdisciplinary approaches; 5) understanding of the pathophysiological and recovery mechanisms of neuronal function in hydrocephalus is poor, warranting further investigation; and 6) both basic and clinical aspects warrant expanded and innovative training programs. The research priorities of this workshop provide critical guidance for future research in hydrocephalus, which should result in advances in knowledge, and ultimately in the treatment for this important disorder and improved outcomes in patients of all ages.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Progressive posthemorrhagic hydrocephalus leads to changes of amplitude-integrated EEG activity in preterm infants.

              Intraventricular hemorrhage (IVH) is the most common cause of brain lesions in preterm infants. Among infants with IVH about 35% develop posthemorrhagic hydrocephalus (PPH) which may lead to secondary injury. Therapeutic interventions to reduce the increased intracranial pressure are invasive and carry a high risk of complications. Amplitude-integrated EEG (aEEG) allows continuous neurophysiological surveillance and may help in defining the optimal timing for intervention in infants with progressive PHH. In this report we show, for the first time, a change in aEEG activity in two preterm infants with PHH. Cerebral activity was continuously monitored by aEEG provided by the Cerebral Function Monitor (Lectromed, UK) in two preterm infants with PPH. With increasing ventricular width, aEEG showed an increased discontinuity without distinguishable sleep-wake cycling in both infants. One infant showed an abrupt onset of a nearly isoelectric pattern without any change in clinical condition. Clinical signs of increased intracranial pressure developed 6-12 h later in both children. In one patient, aEEG activity returned to normal after successful shunting and reduction of intracranial pressure. Continuous neurophysiological monitoring by aEEG may be of value in the diagnostic and therapeutic management of preterm infants with progressive PHH.
                Bookmark

                Author and article information

                Journal
                AJP Rep
                AJP Rep
                AJP Reports
                Thieme Medical Publishers (333 Seventh Avenue, New York, NY 10001, USA. )
                2157-6998
                2157-7005
                27 June 2012
                November 2012
                : 2
                : 1
                : 43-46
                Affiliations
                [1 ]Clinic of Neonatology, Jessenius Medical Faculty, Comenius University, Martin, Slovakia Republic
                [2 ]Department of Physiology, Jessenius Medical Faculty, Comenius University, Martin, Slovakia Republic
                [3 ]Clinic of Neurosurgery, Jessenius Medical Faculty, Comenius University, Martin, Slovakia Republic
                Author notes
                Address for correspondence and reprint requests Branislav Kolarovszki, M.D., Ph.D. Clinic of Neurosurgery, Jessenius Medical Faculty Comenius University, Kollarova 2, 036 01 MartinSlovak Republic kolarovszki@ 123456jfmed.uniba.sk
                Article
                02043
                10.1055/s-0032-1316462
                3653509
                23946905
                7706efb9-8b9a-41a6-a041-f91c44c8c968
                © Thieme Medical Publishers
                History
                : 07 November 2011
                : 23 February 2012
                Categories
                Article

                heart rate variability,newborn,hydrocephalus
                heart rate variability, newborn, hydrocephalus

                Comments

                Comment on this article